Applying gel twice per day, and other questions

Discussion in 'Men's Health Forum' started by infoseeker, Dec 7, 2006.

  1. #1

    infoseeker Junior Member

    I'm asking this for the hub since he's busy doing other stuff but he'll read up later. He just went to the urologist's office today to pick up Testim and has started that, abandoning the androgel (urologist says it has a better track record and our research indicates that's true, so it's worth trying.) The urologist will move on to injections quickly if this does not work. Interestingly, though, both the urologist and internist said, "But you're responding to the Androgel," as if he might not want to switch to Testim.

    Hello - an "improvement" from baseline 200 to a whopping 274 after three months on 10g per day Androgel? He can tell what clinical signs to notice for improvement and has not noticed any (maybe some increased muscle, and that's all.)

    So the first question is: Does it really matter if he applies it twice per day instead of once? (5 g. in the morning, 5. g. in the evening.) That's what he started doing with the Androgel a few weeks ago and would like to continue (Dr. was not in, and/or he forgot to ask this question last time.) We got the idea that there just might be a little more absorbed this way - 10 g. of goo is a lot to spread out in one application, too.

    Second question: Here's what a dr. friend of ours said - he is following this situation by correspondence and here's what he said in looking at a photo from just last weekend:

    "In deed he is not that fat, but you can see the signs of hypotestosteronism.
    I do not remember if his cortisol was checked or not?
    I think by the pic , testosterone need to be given injectable, and thyroid recheck along with cortisol."

    Now, what could he possibly mean - I asked and am waiting for a reply - but what could jump out of a photo to give such an impression? He's got sideburns so it's not like there's no facial hair (other facial hair shaved.) He's big and broad, fat belly that you can't see easily from the front, a sort of fat neck, that's all. A regular looking guy, the kind that would be a bouncer in a bar, the last one you'd pick out of a lineup to have any hormone problems, other than possibly the big gut, which as we all know, more than half the male population seems to sport, particular ex-football-player-looking guys. Anyone have any guesses?

    AND... when he goes to the internist on Monday, exactly what should he ask for in terms of further thyroid and particularly cortisol? Honestly, I hardly know what cortisol is or what tests are performed to evaluate it.

    His TSH was 4.2. Doesn't sound too good to me (I had the idea it should be around 1, under 2 in any case.) Any and all comments appreciated.
  2. #2

    MacDonnell Junior Member

    I don't think he'll need to apply his Testim twice a day. Once, in the morning, immediately after his shower, he should apply the whole 10g. Just wait until his next test. His T will be MUCH higher, I'm betting. androgel did zip for me. Testim made my T SOAR!!!! I had to cut back to 5g/day! I'll let the other guys answer your other questions.
  3. #3

    Megazoid Junior Member

    Any TSH above 2 should be investigated further for hypothyroidism. He need's to get a full thyroid panel done to check t3/4 and Free T3/4.

    If your husband has a bit more fat than muscle (or even just a bit bigger than most guys) it's likely that the fat is causing an excess conversation into E2. This be resulting in a lower than normal T level and a great increase in E2. It's also possible at this stage to mention that his own body has shutdown (HPTA) and that the androgel isn't providing enough T over E2 and thus resulting in the low reading,

    Testim DOES provide a higher total T and Free T, Mac made a good point here. But it sound's as if the gel's just won't work as well with your husband. I found that applying the gel only to my shoulder blades and upper arms reduced the E2 for me. Also get hold of some Zinc and DIM also to help reduce the E2.
  4. #4

    marcusruhl Banned

  5. #5

    HDH Member

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  6. #6

    infoseeker Junior Member

    I just ignored that. But back to the conversation:

    Thanks for the suggestions. He already takes zinc. He does not have any of the estrogen symptoms I've heard mentioned here (nothing weird on the breast area - and I've seen someone else affected by that, so I know what it looks like) and no problems um... well, I'll let him talk but there's no delay in anything.

    I guess I keep wondering if thyroid and testosterone are connected in any way, like if one is corrected, the other may be, also.

    Anyone have anything to say about cortisol? So we won't just say, "Doctor, check my cortisol." We like to seem kind of educated when seeing our (nice-enough) doctor - sometimes they take people more seriously and do less head-patting if you seem to know what you're talking about (without sounding too much like a junior would-be medical student, of course, but this guy is nice and doesn't mind the jr.-amateur-M.D. attitude very much).
  7. #7

    kincaiddave Junior Member

    I don't have a clue what could have been seen in a photo to make any diagnosis.

    TSH that high is definately suspect for hypothyroid, but is not the best test. Like Megazoid mentioned, you have to have free t3 and free T4 checked to see what thyroid hormones are being made and in the blood, not what is being called for (TSH).

    Cortisol is necessary to cary the thyroid hormones into the cells for them to do their thing. Adequate or too much thyroid hormone(s) without adequate cortisol to help at the cellular level can lead to feeling jittery, etc.

    If cortisol and/or thyroid is inadequate, it can cause low T. Adding the exogenous T can (will?) cause cortisol to lower which can lead to more or greater hypothyroid symptoms.

    You should post at the forum and study up here - .
  8. #8

    infoseeker Junior Member

    Thanks for explaining about cortisol. I feel that between our better-than-average M.D.and the urologist who doesn't seem like a complete slouch and our acquaintance/friend I quoted above, we'll get to the bottom of this. Thanks, all.

    I wonder if he'll have to go to an endocrinologist, though (and I've read about how fond of them you guys are - NOT!) The internest already shuffled him off to the urologist (and rightly so) by admitting that he's getting out of his area of specialty.
  9. #9

    infoseeker Junior Member

    By the way, I don't mean to duplicate information, but for anyone who hasn't read my other posts, the reason he went to the dr. in the first place was for blood sugar problems, discovered at home (with a friend's meter) probably-not-coincidentally along with a sudden onset of quasi-ED-type problems, libido, too. He's been eating like a monk and exercising too and not losing an ounce, and the max. dose of metformin thrown at the problem has done next to nothing, although his A1C went down from 7.0 (tested at home) to 6.1 (before starting medical treatment, just by the aforementioned monk-style-eating and excercise) to 5.9 after three months of metformin which hardly made the blood sugar budge (we're told that the testosterone problem is all tied up in his insulin resistance, and that attacking the blood sugar would help with other probelms, and at any rate, his blood sugar did need attacking.)

    Started Byetta one week ago, and for the first time in SIX MONTHS, (best measurements ever) numbers are 85 in the AM and as low as 73 at random other times (as recently as last week, we were looking at the average 110 in the AM and anywhere from 85-170, with proper diet, other times.)

    THIS IS HUGE. AND.... update as I speak - he just got off the scale and there's 5 lbs. lost!!!

    Don't be so fast to rag on Byetta, any of you who might. This is the first real progress of any sort we've seen since this debacle started in late spring.
  10. #10

    pmgamer18 Member

    How is his libido and ED problem now is it better. Dr.'s dont feel low normal Cortisol levels are a problem and don't believe in Adrenal Fatigue but because of this it hard to get one to treat this yet is the dam Dr. looked in this desk ref. it states to test cortisol before putting some one on thyroid meds. Read the sticky Adrenal Thread.
  11. #11

    infoseeker Junior Member

    He would say, and I would also say "no" to your question, but it's only been 24 hours now on the Testim. So unless his T level has gone up past 274 like it was at last lab test, no wonder.

    Thanks - I'll read the sticky thread you mentioned. At least our doctor friend suggested testing the cortisol, which means that some doctor somewhere must understand a little about it.

    Same thiing with the blood sugar - it's only been two days since it's been corrected, finally. So I guess he'll have to check in later. By the way, the urologist who is seeing him now for newly-developed Peyronie's (not sure if you caught that I mentioned it a week or so ago) says that this ED-Peyronie's is a classic result of diabetes, and the urologist is determined to get the testosterone up since he doesn't believe anything will be fixed without it. So at least he's somewhat on the ball, which is better than some horror stories I've heard about. I guess he'll check in sooner or later with an update!
  12. #12

    pmgamer18 Member

    Great I feel you all are on top of this and all it can do now it get better. TRT helps with sugar and if his cortisol levels are off fixing this helps alos with sugar.
  13. #13

    mrw2k Junior Member

    Sugar below 100 all day today! Started off at 85 fasting and I've checked it 3 times. Hopefully the libido and drive will start getting back to normal with the switchover to Testim. If not I'll probably be investigating injections. I'll keep you all posted.

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